Editorial: Technology spreads expertise
Over the last few decades, the spread of HIV/Aids and tuberculosis, along with the continued threats from measles, polio and malaria, have cost the lives of millions of people and affected countless families in ACP nations. The loss of labour potential and, in particular, the reduction of manpower in the agricultural sector, threatens food security and can severely limit a country’s growth. But health projects throughout the world are using now a wide range of ICTs to connect rural communities to the expertise often only found in big cities.
While regional hospitals and rural clinics often have very limited resources, many do have the basic equipment for analyzing and diagnosing most ailments. The problem is that the staff working in many of these smaller health centres don’t always have the expertise to read the results accurately and make a precise diagnosis.
Microscopes, for example, are widely used as a diagnostic tool in many rural medical laboratories. But while local technicians might be able to take a sample and prepare it for viewing, they might not be able to identify exactly what the microscope reveals. To help solve this problem, researchers at the Netherlands Organization for Applied Scientific Research (TNO) have developed a device which connects the camera from a mobile phone to the eyepiece of a microscope. With the sample lined up, ready for analysis, the lab technician simply takes a picture and sends it via MMS (multimedia messaging service) to a specialist to examine. Within minutes, the specialist can call the health centre with the results and a precise course of treatment for the patient.
Faced with a similar problem, a group of doctors in Mali decided to develop a system where rural medical staff can send x-rays to expert radiologists in the capital, Bamako, for diagnosis or a second opinion. The Malian Society for Medical X-rays (SOMIM) involved local software developers who came up with a system where health centre staff could send confidential patient details to specialists via the internet. The result was an open source program called OpenYalim, currently used by three regional hospitals with plans to extend it further throughout the country and the region.
SOMIM also helped to set up an e-learning and e-consultation project to support medical staff working in rural areas. Nurses and doctors can now logon to a dedicated website to download lectures and seminars and ask for second opinions from colleagues located elsewhere. The system helps staff to continue their training and keep up-to-date with the latest techniques.
Supporting rural healthcare workers was also a priority for Baobab Health, an NGO based in Malawi. They developed the Touchscreen Clinical Workstation (TCW) specifically to withstand constant use in a busy health centre under hot, dry, dusty conditions. It has no moving parts, there’s no need for an external computer mouse or keyboard and its low energy requirements mean the system can operate for many hours when disconnected from mains electricity.
The software installed on the TCW guides staff through a number of procedures ranging from patient registration to continuing care for people living with HIV/Aids. Depending on the situation, the healthcare worker follows the on-screen questions and enters the data via a touchscreen keypad. The system can record the data for later analysis or store it as part of the patient’s medical record.
For years, governments and other healthcare providers have tried, often in vain, to distribute medical expertise to small towns and remote areas. But communication technology can now provide rural health centres with a vital link to specialist advice located elsewhere in their own country or even abroad. The small clinics get the support they need and health ministries save money from increased efficiency.
But, more importantly, patients benefit. They can get fast, accurate diagnosis and prompt treatment. They no longer have to travel long, costly distances to an overcrowded urban hospital to be treated for a minor illness. And rural communities gain by having a strong, local workforce with more time and energy to develop their businesses, infrastructure and farmland.

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